Prevalence and Incidence of Dry Eye and Meibomian Gland Dysfunction in the United States

Abstract

ImportanceDry eye is a common clinical manifestation, a leading cause of eye clinic visits, and a significant societal and personal economic burden in the United States. Meibomian gland dysfunction (MGD) is a major cause of evaporative dry eye.ObjectiveTo conduct a systematic review and meta-analysis to obtain updated estimates of the prevalence and incidence of dry eye and MGD in the United States.Data SourcesOvid MEDLINE and Embase.Study SelectionA search conducted on August 16, 2021, identified studies published between January 1, 2010, and August 16, 2021, with no restrictions regarding participant age or language of publication. Case reports, case series, case-control studies, and interventional studies were excluded.Data Extraction and SynthesisThe conduct of review followed a protocol registered on PROSPERO (CRD42021256934). PRISMA guidelines were followed for reporting. Joanna Briggs Institute and Newcastle Ottawa Scale tools were used to assess risk of bias. Data extraction was conducted by 1 reviewer and verified by another for accuracy. Prevalence of dry eye and MGD were combined in separate meta-analyses using random-effects models.Main Outcomes and MeasuresPrevalence and incidence of dry eye and MGD in the United States. Summary estimates from meta-analysis of dry eye and MGD prevalence with 95% CI and 95% prediction intervals (95% PI).ResultsThirteen studies were included in the systematic review. Dry eye prevalence was reported by 10 studies, dry eye incidence by 2 studies, and MGD prevalence by 3 studies. Meta-analysis estimated a dry eye prevalence of 8.1% (95% CI, 4.9%-13.1%; 95% PI, 0%-98.9%; 3 studies; 9 808 758 participants) and MGD prevalence of 21.2% (95% CI, 7.2%-48.3%; 95% PI, 0%-100%; 3 studies; 19 648 participants). Dry eye incidence was 3.5% in a population 18 years and older and 7.8% in a population aged 68 years and older. No studies reported MGD incidence.Conclusions and RelevanceThis systematic review and meta-analysis demonstrated uncertainty about the prevalence and incidence of dry eye and MGD in the United States. Population-based epidemiological studies that use consistent and validated definitions of dry eye and MGD are needed for higher-certainty estimates of dry eye and MGD prevalence and incidence in the United States.

Seasonal variations in presenting symptoms and signs of dry eye disease in Norway

“…The lack of a consistent seasonal variation in DED could be related to a geographical impact. In the US, the prevalence of DED appeared higher in the southern regions 16 . In our study, all patients were examined at a single location.…”

Patient barriers and facilitators for making environmental and behavioral modifications for dry eye in the United States

“…Second, the socioeconomic status definition used in the current study focuses on two of the five key domains of social determinants of health (economic stability and education). Studies have shown that dry eye disease–related outcomes may be impacted by the three other domains as well: health care access and quality (e.g., we did not ask about whether the respondent had regular access to an eye care provider), 28,29 neighborhood and built environment (e.g., we did not ask about the respondent's occupation, such as whether they worked indoors or outdoors), 14,15,22,30–34 and social and community context (e.g., we did not ask about the respondent's residential geographical region and weather-related context in the United States) 29,35,36 . Third, we did not ask whether the respondent's dry eye symptoms may have been related to individual factors, such as contact lens use and underlying health conditions.…”

“…Dry eye disease is prevalent in the United States. Our systematic review and meta-analysis of recent (2010 to 2021) studies found the overall prevalence in the United States to be 8.1% (95% confidence interval, 4.9 to 13.1%) 5 . Dry eye disease–related symptoms, such as dryness and visual difficulty, are among the leading concerns that make patients seek eye care.…”

Dyslipidemia Exacerbates Meibomian Gland Dysfunction: A Systematic Review and Meta-Analysis

“…Dry eye is a multifactorial age-related ocular surface disease with a high prevalence of disease in the world, ranging from 5 to 50% [ 1 , 2 , 3 ]. Dry eye is characterized by the instability of tear film on the ocular surface, leading to the various symptoms that influence the productivity at the workplace due to the lower quality of vision [ 4 ].…”